2021-2023 RENEWAL APPLICATION - South Carolina

2021-2023 RENEWAL APPLICATION

Renewal Instructions/Requirements:

? Check or money order only in the amount of the biennial renewal fee made payable to LLR?Board of Cosmetology. (All fees are non-refundable. A returned check fee of up to $30, or an amount specified by law, may be assessed on all returned funds.)

? License Renewal Fees (select each license being renewed below):

Cosmetologist (RC) $52 Instructor, Registered Cosmetologist (IRC) $82 Cosmetologist Inactive (RC INA) $52

Esthetician (ES) $52

Instructor, Esthetician (IES) $82

Esthetician Inactive (ES INA) $52

Nail Technician (NT) $52 Instructor, Nail Technician (INT) $82

Nail Technician Inactive (NT INA) $52

Instructor, Registered Cosmetologist Inactive (RC INA) $82 Instructor, Esthetician Inactive (IES INA) $82

Instructor, Nail Technician Inactive (INT INA) $82

? After March 10th your license is lapsed and must be reinstated.

? If you have had a legal name change since your initial licensure or since your last renewal, please attach the legal documentation with this renewal form (Marriage Certificate, divorce decree, court documentation).

LICENSEE INFORMATION

Name:

License No.:

Since you were licensed, have you legally changed your name? Yes No Prior Name: If yes, please submit legal documentation supporting the change. (Marriage certificate, divorce degree, etc.)

Email:

Last Five Digits of Social Security No.: xxx-x -

Home Address:

City:

State: Zip:

Mailing Address: Home Phone:

(If different than above)

City: Cell Phone:

State: Zip:

INACTIVE STATUS Do you wish to place your license(s) inactive?

(If Yes, CE classes are not needed at this time, but you must pay the renewal fee to remain inactive through March 10, 2023.)

Yes No

CONTINUING EDUCATION (CE)

Cosmetologists, Nail Technicians and Estheticians must show satisfactory evidence of twelve (12) contact hours of instruction during the preceding licensing period. Instructors must show satisfactory evidence of twelve (12) contact hours geared toward teaching. Attach certificates of completion received from USC.

1. Initial Licensees, those licensed between October 1, 2018 and September 30, 2020, are

not required to complete continuing education during the first licensing period. During the

second licensing period and thereafter, the continuing education requirements will apply.

Were you initially licensed by the Board between the period of October 1, 2018 and

September 30, 2020?

Yes No

2. Have you completed the required number of continuing education hours prior to renewing your license? (If you answered Yes, you must remit documented proof of CE certificates). Yes No

2021-2023 Cosmetologist Esthetician Nail Renewal (11/20)

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PERSONAL HISTORY QUESTIONS Answer the following questions. A detailed letter of explanation or updated documentation is required for "Yes" answers.

1. Since your initial application or since your last renewal of your license with the Board, have you been convicted, pled guilty, or pled nolo contendere (no contest) to a felony of any kind or to a non-felony crime involving drugs or moral turpitude?

If Yes, you must include a full written explanation, criminal background report and court documents with your renewal application.

Yes No

2. Since your initial application or since your last renewal of your license with the Board,

has there been any change in the status of your lawful presence in the United States since

your initial licensure?

Yes No

ATTESTATION

I HEREBY swear/affirm I have read all questions on this renewal application and have answered truthfully, accurately and completely. I hereby acknowledge that failure to answer these questions truthfully, accurately and completely shall constitute cause for the initiation of disciplinary action against my South Carolina licensure.

Signature:

Date:

PRIVACY NOTICE

South Carolina law requires the agency to collect personal information which is only disseminated as required by law. The South Carolina Freedom of Information Act ensures that the public has a right to access appropriate records and information possessed by a government agency. Therefore, some personal information on your renewal application and other documents on file may be subject to public scrutiny or release. The Department collects and disseminates personal information in compliance with The South Carolina Freedom of Information Act, the South Carolina Family Privacy Protection Act and other applicable privacy laws and regulations. Additionally, the Department shares certain information on the application with other governmental agencies for various governmental purposes, including research and statistical purposes.

2021-2023 Cosmetologist Esthetician Nail Renewal (11/20)

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